HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 W
(772) 462.1553 ENt:�
FILLED LAND AFFIDAVIT OCT 2 92019
Permitting Depa�ment
St. Lucie County
I, the undersigned, am the owner of the following described property, . �t;,
Cobblestone Dr, Fort -Pierce, FL ` 4 Y
(Parcel id#/Legal description/Address) Q(j„�
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
'Br6AN W t:141A91&k
Property Owner Name (Please Print)
Property Owner Signature
STATE OF FLORIDA. COUNTY OF Brevard
9/24/2018
Date
ACKNOWLEDGED BEFORE, NIE THIS 24 DAY OF September ao %0 ,
BY W110 IS PERSONALLY KNOWN TO NIE (LI) OR WHO IIAS
PRODUC AS IDENTIFICATION.
SIGNATURE OF NO'rARY UBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER SVOtII1Y Florida
if RU
QL'`JIIC Slot, OI
{SEAL} xor °� SandKa 4cp 1
GG
e 020251
try Commission
q & t xP.tes Oy71 (�020
r `tom • _
SLCPDSD Revised 04/ I V-101 I